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Safe injection site in Toronto would boost public health: Editorial

Toronto’s medical officer of health, Dr. David McKeown, is right to call for a safe injection site for illegal drug users.

Dr. David McKeown, Toronto's medical officer of health, is calling for a safe injection site for illegal drug users. (Steve Russell / Toronto Star) | Order this photo

Fri., July 5, 2013

Denying addicts a safe, supervised place to inject the drug of their choice won’t rehabilitate anyone or make them go away. It only leaves people shooting up in Toronto’s parks and alleys, stairwells and public washrooms — putting their own health, and that of others, at grievous risk.

That’s why the city’s medical officer of health, Dr. David McKeown, is calling for creation of a supervised injection site for illegal drug users. This is about following scientific evidence to determine best practices, and putting community safety ahead of a desire to punish addicts or just abandon them to their fate.

The Toronto Board of Health is to consider McKeown’s recommendation next Wednesday and it warrants strong support. With board approval, the measure would go to Toronto city council and then to Queen’s Park for funding. But, unfortunately, opposition to opening a safe injection site in Canada’s largest city remains strong.

Ontario Health Minister Deb Matthews has already said the province has no intention of moving forward with any such site. And Toronto Mayor Rob Ford was quick to voice his disapproval of a supervised injection centre for addicts, declaring it the worst thing that could happen to the city.

Unlike those who enjoy smoking crack cocaine, just to take an example, people who inject illicit drugs like heroin face more than double the risk of overdose. And that’s just part of the health threat documented by McKeown in a report that accompanies his recommendation. One in five people who inject drugs in Toronto have done so with needles previously used by someone else. Even worse, the rate of needle sharing among street youth runs above 40 per cent.

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That’s especially worrisome given that more than 60 per cent of injection drug users studied in Toronto tested positive for hepatitis C, and 6 per cent were found to be infected with HIV.

Not only are overdoses reduced but the spread of HIV and hepatitis C is cut; staff are able to steer people into detox and addiction treatment services; public drug use is lower, as is the incidence of publicly discarded needles; and research shows there’s generally no increase in crime when a safe injection site opens in a neighbourhood.

It’s called Bill C-65 and it would require any group hoping to operate such a centre to meet 26 requirements, including police checks on staff going back 10 years, provision of detailed neighbourhood crime data, plus letters of support and consultation reports from an array of government officials and community groups.

These requirements are “extremely onerous and disproportionate to what is required for other health services,” McKeown writes in his report, adding they “pose significant barriers” to care. That’s why he is also urging Toronto’s board of health to formally protest this odious federal initiative, as well it should.

In matters of public health — quite literally, issues of life and death — it’s vital to set emotion aside and follow where the science leads. And the evidence clearly indicates that supervised injection sites can effectively cut the unsafe, hidden drug use haunting communities. That, alone, should be reason enough to proceed.

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